Wednesday, October 21, 2009

Health Care Wednesday: 315,023 Calls Edition

There's something the President is not telling us. And it's rather annoying for him to be lecturing us about coming together when, frankly, we are together. Unified around a campaign promise he is so blithely blowing off. We have the best chance at reform in a generation, and this White House is trying awfully hard to get the bare minimum with the least possible effort. We deserve to know why.

A preliminary analysis from CBO may have sealed the deal. Speaker Nancy Pelosi is preparing to move ahead with a "robust" public option--one that reimburses hospitals and providers at Medicare rates, plus five percent--in the House's health care bill. She is briefing her caucus about the plan's savings tonight, and, pending the approval of a sufficient majority of members, will adopt the measure as part of the complete reform package.
The analysis finds the reconstituted House proposal to be deficit neutral, and require less than $900 billion in new spending, over ten years.
The bill remains nominally more expensive than the Senate Finance Committee proposal, but would cover 96 percent of all Americans, providing greater bang for each federal dollar spent. And, aides note, the bill that comes to the floor of the Senate will be a hybrid of the Finance and more expensive HELP Committee bills, so the price is expected to rise.
The move is sure to make progressives ecstatic, and puts Senate leaders, who have been unable to reach any decisions about their preferences for a public option in their own bill, in an uncomfortable position.
In recent days, Pelosi has insisted that she intends to send House negotiators to a health care conference committee with the maximum possible leverage for the public option. And House health care principals have been working doggedly to keep the price of reform down with the help of the public option--so in a sense, the news of this final push comes as little surprise: Pelosi is, as expected, using the fiscal responsibility of the robust public option to win over enough skeptics in her caucus to pass it. And she is, reportedly, very close to doing that.
By tying reimbursement rates to Medicare, the government would be able to spend less money per individual on subsidies in the health insurance exchanges. One of the major critiques of the Senate Finance bill is that the spending totals are kept low by denying subsidies to middle income Americans, and without providing a systemic corrective to insurance industry waste and abuse. In the House bill, greater subsidies, and the public option address that issue.

During a House Democratic caucus meeting last night, the Speaker conceded that she has not yet lined up the 218 votes she'll need to get the bill passed, though, according to a senior Democratic staffer, Pelosi said, "We are very close and I count tough."
As part of this tough count, the Speaker instructed House Democratic Whip Jim Clyburn (D-S.C.) to start canvassing the caucus, getting firm answers from every member on whether they're prepared to vote for the bill. Going into this week, there are dozens of House Dems who've noncommittal. Today, the leadership expects every Dem in the chamber to get off the fence and pick a side.
The caucus is scheduled to meet again today to see where the party stands.

There's been plenty of activity on the Hill since late yesterday on health care reform, so let's take stock of where we are now. We'll tackle the Senate first, and the House in the next post.
The Reid/Baucus/Dodd negotiations continue, with updates for the rest of the Senate Democratic caucus, though everyone involved is being tight lipped about developments. By most indications, the discussions are focusing on the easier elements first -- providing a foundation of measures that everyone seems to agree on -- and working their way up to the more contentious provisions.
During a press briefing in the afternoon, Senate Majority Leader Harry Reid (D-Nev.) kinda sorta made some news.

Asked Tuesday whether the talks were leaning "toward or against" a public option, Reid picked option 3. "We're leaning toward talking about a public option," he said. "We have -- no decision has been made. We had a -- not a long discussion last night on public option. I've had a number of meetings in my office dealing with Democrats and Republicans on the public option aspect of it. And when the decision's made to send this on to the [Congressional Budget Office], I will have made a decision as to what we're going to do with the public option. It's not done yet."

The notion that Senate leaders are "leaning toward talking about" the idea generated some chuckles, but it may be more encouraging than it appears. As Ezra explained, "The negotiators can do one of two things with the public option. Figure out a compromise to put in the bill during the negotiations phase, or ignore the issue completely and let it get decided on the floor. In other words, they can talk about it or they can decide against talking about it. This quote suggests that they're leaning towards figuring out the issue in negotiations rather than leaving it to the floor. That's a big win for public option advocates. If they get something in during negotiations, opponents will need to muster 60 votes to remove it on the floor. If the public option has the 52 supporters that Sen. Tom Harkin estimates, then that's impossible."
There remains plenty of optimism in some corners. Harkin told MSNBC last night, "I'm telling you, we're going to have a public option in this bill." Salon's Mike Madden added that "momentum ... seems to be shifting toward the public option, even if it's shifting slowly."
Elsewhere in the Senate, Sen. Ben Nelson of Nebraska, the chamber's most conservative Democrat, who has been strongly opposed to a public option, signaled a willingness to support the measure if it were watered down a bit, with either an opt-out or a trigger.
Colorado Sens. Mark Udall (D) and Michael Bennet (D), meanwhile, also spoke up yesterday, urging senators to commit to letting the Senate vote, up or down, on a reform bill with a public option. Sen. Bernie Sanders (I) of Vermont, who caucuses with the majority, also continues to push this message: "I would hope that [President Obama] would remind every member of the Democratic caucus that the function of the Republican Party -- which the American people are very clearly seeing -- is obstructionism and is saying no in the midst of a terrible, terrible health care crisis. So what the president -- and all of us -- should be asking is every member of the Democratic caucus to vote yes to stop Republican filibusters."

When Diana Furchtgott-Roth from the Hudson Institute attacked everything from the public option to the health bill that passed out of the Senate Finance Committee last week, Whitehouse remarked that she “veered across three lanes of traffic.”
“Did you actually read the bill that is the subject of today’s hearing?” he asked.
When Whitehouse asked her about the issue she had failed to focus on — bankruptcy — Furchtgott-Roth replied simply that the current system does a good job.
“Did it do a good job for Ms. Burns?” Whitehouse rebutted, visibly frustrated. Furchtgott-Roth simply replied that Burns had been in a bad situation.

Kerry Burns’ son died of cystic fibrosis and she went into bankruptcy from the medical bills.

The Congressional switchboards have been lighting up all day with health care supporters calling members through the Organizing for America call parties, and OFA is about to hit its second goal of 150,000 calls.
A staffer for Rep. Jan Schakowsky (D-IL) called to detail that office's experiences with the calls today, saying the volunteers offer a sample of varying perspectives on health care. Some are calling for a single-payer system, some are asking the Congresswoman to stand firm for a public option, while others are offering general support for President Obama's plan.
The staffer told TPMDC that more than 100 calls flooded in today. During a daily staff meeting they usually can have one person listen for the calls, but today they had to halt the meeting so a handful of aides could answer the phones.
"It's more calls in a single day than we've ever received on health care, and pales in comparison to efforts done by opponents. It's no small feat," the Schakowsky staffer told me. "It's definitely noticed and having an effect."
Work for a member of Congress? Is your phone ringing? Please share your stories with us.Late update: OFA raised the goal again to 200k, and as of 4:50 are past 168k.
Americans United for Change sent reporters a story suggesting the overwhelming majority of the calls are in favor of the public option.Later update: At 6:06, nearly two hours before President Obama would join his supporters on the Webcast tonight, OFA announced it had broken the 200,000 goal. As of this writing at 7:15, they are almost at 215,000 calls.
Andy Phelan with Rep. Hank Johnson (D-GA) got in touch today to tell me his office's experience, which mirrored anecdotes we've been hearing all day.
He said they had received about 150 calls split between the district office and the Hill office, with all but three of them in general support of health care reform.
Johnson is one of the progressives who threatened to vote against a final health care bill if it doesn't include a "robust" public option but Phelan said once the bill is on the floor his boss will have to "weigh those options for himself."

OFA email this morning:

It's late; I know you've gotten a lot of messages from us recently, and everyone here at OFA headquarters is pretty tired. But the last reports of calls and commitments are just coming in from events on the West Coast, and I wanted to share the news with you.

As you know, we set a big goal: 100,000 calls to Congress placed or committed to in a single day by OFA supporters and allied organizations. By 2:30 p.m., you had crushed it. So, we gulped and said let's go for 200,000, not knowing what would happen. But the calls just kept pouring in -- keeping phones ringing off the hook in congressional offices in D.C. and your representatives' district offices around the country.

Then, OFA supporters gathered in over 1,000 living rooms and community centers from Macon, Georgia to Missoula, Montana. You called hundreds of thousands of key voters in your community and got them to agree to call Congress and speak out for reform, too. President Obama joined in at a call party in New York -- and he had some amazing words of support for the folks like you who make this movement possible.

I'm looking at the numbers, and with almost all of the reports now in, the tally wasn't 200,000 calls placed or pledged -- it was 315,023. You did it.

President Obama tonight pleaded with Democrats to remain unified in the final health care stretch, detailing for his loyal supporters in New York the good things in "the bill you least like."
"There are going to be some disagreements and details to work out ... but I want to say to you Democrats, let's make sure that we keep our eye on the prize," Obama said during a Webcast for the thousands of Organizing for America volunteers who were gathered for call parties across the country.
"Sometimes Democrats can be their own worst enemies, Democrats are an opinionated bunch ... y'all are thinking for yourselves," he said. "I like that in you, but it's time for us to make sure that we finish the job here. We are this close and we've got to be unified."
Obama said "the bill you least like in Congress right now, of the five that are out there," would give 29 million uninsured Americans health care, would ban preexisting conditions and would create an exchange that would encourage competition among ensurers.

from the comments, which are all like this, one might surmise it is Obama who needs to get on board, and I agree:

Fine and dandy, O-Man ... but we don't want that 'bill we like least.' It blows. Push for that, and you'll be talking to some pretty skinny crowds in 2012. A real bill is in your hand; just close your fingers around it!

Well Mr President I feel as though 'we' should be asking 'you' to get more unified with 'us' because we should not be settling for the least of these bills and in fact it would be a disaster.
If every bill was not trying to install a 'mandate' on the American people, we would be a little less concerned with this health insurance/care reform falling short.
As it is I will not accept a mandate without a true public option that reduces costs and is available to 'all' Americans.
I think it is you who needs to get 'on board' here.

Which sounds nice and all except that it's not so much I "don't like" that one bill, like we were picking paint colors or something, it's that one of the bill has the potential to ruin my life, me personally, as a person who lives constantly on the edge of being forced into contractor/self-employment work.
Give me a bill which fails at fulfilling of my ideological desires and hey, if it helps someone, somewhere, let's go for it anyway! A tenth of a loaf really is better than no loaf.
But give me a bill which potentially creates a situation where I cannot get health insurance which pays my medical bills, but I am being forced to pay for insurance anyway...? I am forced to do anything I personally can to keep that bill from passing, just out of self preservation. This loaf us worse than no loaf. This loaf is poisoned.
Or, more to the point: no mandates without a public option. There can't be negotiation on this. If the government requires purchasing insurance, then the government has to take on the responsibility of making sure some minimally acceptable insurance plan exists to buy.

If Pres. Obama thinks the prize is just getting a bill passed that claims to be health care/health insurance reform he may win the short term political battle but leave the costly war raging. Since single payer is out of the question and even a real public option is not a done deal, what we will likely get is minimal reform and there will be little savings for middle class families as candidate Obama promised.

As he did earlier in the night at a separate DNC fundraiser, the president pointed a finger to Democrats and Republicans for their role in health care reform. He called on Democrats to be united as they “keep their eye on the prize” in health care reform, and that when they get a bill they have to do "everything they can” to support it.

“Sometimes Democrats can be their own worst enemies. Democrats are an opinionated bunch. You know the other side, they just kind of do what they’re told. Democrats, ya’ll thinkin’ for yourselves. I like that in you, but it’s time for us to make sure that we finish the job here, we are this close and we’ve got to be unified.”

There's something funny going on here. We've got the polls on our side, we've finally got momentum on our side after the Teabagger mess in August, and the president himself supported the public option during the campaign, and claims to still support it as the best solution to our health care mess. Then why isn't the White House pushing for a public option?

We're missing something here. A political friend at dinner last night suggested that maybe the White House promised to kill the public option as part of its secret deal with Big Pharma last spring. I have no idea if that's true, but something is wrong here, some piece of the puzzle is missing. It's becoming increasingly clear that the President has no intention of including a real public option for everyone in the final bill. If he did, he would publicly push for it. He's refused. His staff has refused. In politics, as in life, if you tell your opponent that you're not terribly wedded to your proposal, then your proposal is toast.

There's something the President is not telling us. And it's rather annoying for him to be lecturing us about coming together when, frankly, we are together. Unified around a campaign promise he is so blithely blowing off. We have the best chance at reform in a generation, and this White House is trying awfully hard to get the bare minimum with the least possible effort. We deserve to know why.